Over six months ago I wrote about WIN News, and its decision to interview anti-vaccination campaigner, Meryl Dorey, in a segment alerting the community to a Measles outbreak. The interview got all the negative attention it deserved, making it all the way to Media Watch, and the industry regulator, the Australian Communications and Media Authority (ACMA). ACMA is still to deliver its verdict over the interview, which it deemed was worthy of investigation (this is no mean feat).

If we go even further back to Ellen Fanning’s excellent 60 Minutes piece on immunisation, Getting The Point(June 2011), national audiences were introduced to this pair:

Viera Scheibner belittles her partner Bronwyn Hancock (right).

Here is the transcript, showing exactly what Hancock’s friend and ally thinks of her:

ELLEN FANNING: If she hasn’t got the extensive knowledge, why on earth is she writing these articles on the website?

VIERA: Maybe you have a point then, yes. That’s right. Maybe you have a point there, okay.

Getting the point, indeed. If only Channel Seven News had have got the same point:

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The Channel Seven News story was to introduce the roll-out of the new MMRV vaccine, to be given to children at 18 months of age, meaning there will be one less needle for kids. Excellent! Or so you thought. Threaded through the story (which is mostly excellent), is the fear-mongering presence of the unqualified harbinger of death and destruction, the anti-vaccinationist; this time wearing the Bronwyn Hancock mask. What was Hancock’s contribution? This mangled set of word-things-brain-damage:

Convulsions, uh, can occur and they are associated with, um, in some cases with, uh, permanent brain damage.

1 in 15 children with measles develops pneumonia and 1 in 1,000 develops encephalitis (brain inflammation).

For every 10 children who develop encephalitis, 1 dies and up to 4 have permanent brain damage. About 1 in 100,000 develops SSPE (brain degeneration), which is always fatal.

Side effects of vaccination:

About 1 in 10 has discomfort, local inflammation or fever. About 1 in 20 develops a rash, which is noninfectious. 1 in 1 million recipients may develop encephalitis (inflammation of the brain) [which is even more rarely permanent].

What is particularly interesting to me is Seven News’ decision to include an anti-vaccinationist in a factual story concerning public health. We know anti-vaccinationists are not honest brokers of accurate information. We know they are never qualified to speak on that which they are asked. We know that they feed on and stoke the flames of fear, based on their reckons, not facts. So, why are they sought out? The cynic in me jumps to ratings. But, it is more than that. It is about this incessant need to present bollocks dressed up as balance.

What is really interesting to me is that Bronwyn Hancock was cut from the online version of the story. Why was that? The stories are identical. The YouTube version (above), recorded live, contains Hancock. The official online version does not. Does Seven News already know that they may have botched this one?

In this wonderful instructional video on false balance, Dara O’Briain lays it out simply:

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Similarly, if a revolutionary surgery has been proven effective in removing brain tumours, do we seek a balanced view from Andrew, the guy in the video store, who happens to be anti-brain surgery, to counter the views of Professor Mitchell? No, we don’t.

If a diesel mechanic of thirty years experience is advising punters on how best to avoid getting water in their lines, do we turn to Tristan the financial adviser, who happens to be anti-mechanical intervention, to advise us that water is natural and that we should therefore allow our diesel engines to grind to a halt, as nature intended? No, we do not.

Then, why on earth do news programs, who are meant to be our reliable source of factual information, interview people on things they know nothing about, whose intent is to see immunisation rates drop to zero? In effect, these people want to see more children dead, from disease, because that’s how the stronger children survive. How *cough* Darwinian. How very 19th Century.

I urge you to make your thoughts known, to Seven News, here [edit April 7: as per complaints process questions, The segment aired on Seven News Sydney, at 6pm, in Sydney, on March 28 2013].

If you are unsatisfied with the response to your complaint, you may upgrade your complaint to ACMA. Details will be provided by Channel Seven in their response.

I worked with Viera Scheibner many years ago. She is not medically qualified. Her doctorate is in palaeontology, (she studied a group of microfossils called foraminifera). Her ideas were weird then. Now they are weird and dangerous.

Hi guys, Yes, balance is certainly important. Therefore I thought I’d look myself at the government disease notifications and cited complication rates in the unvaccinated, compared to the published rates after vaccines, in order to balance one risk against the other.

Convulsions seem to be a major issue that has been highlighted, and would be a good marker for comparison, so I sought to compare the rate of convulsions on either side.

The results are interesting. Averaging over the years 2001 to 2007 (the most recent 7 years available, whose figures are in Vaccine preventable diseases in Australia, 2005 to 2007, Vaccine preventable diseases and vaccination coverage in Australia, 2003 to 2005 and Vaccine preventable diseases and vaccination coverage in Australia, 2001 to 2002)…

I divided the 92 average annual number notified cases of measles, mumps and rubella in all children (aged 1 to 17 years) by the 18000 average annual number of children unvaccinated (for those diseases), to get a maximum of 1 in 200 average chance of an unvaccinated child contracting measles, mumps or rubella (maximum, since some of those cases would actually likely be in the vaccinated instead).

Then I multiplied that 1/200 by the maximum of 1/700 of those on average (including those with immunodeficiencies) who were reported to have suffered any neurological complication (including convulsions) from any of those diseases, to get a net rate of 1 in 140,000 unvaccinated children who would suffer a neurological complication from any of those diseases.

I then compared that rate (1 in 140,000) to the 1 in 3,000 rate cited of febrile convulsions from the MMR vaccination per child (previously healthy enough to be vaccinated)(* see NOTE below). So the result was a chance of febrile convulsions alone from the vaccine being about 50 times higher than the chance of getting any neurological complication from any of the diseases.

So I expect I must have made a major error. Could someone please tell me what I have done wrong there? Thanks!

*NOTE: I did not include the rate of quite commonly reported vaccine reactions such as headaches and irritability, which are also elsewhere, i.e. generally, said to be signs of possible undiagnosed mild encephalitis or meningitis, together with other common vaccine reactions such as high fever and/or loss of appetite. I also ignored the higher rate of 1 in 1,000 for any type of convulsion after the MMR vaccine which rate is cited by some other governments such as the Irish government.

The problem is your data sets are not consistent, nor complete. Whilst I suppose it may be theoretically possibly to do this with the data that is available to the public from general websites the lack of detail of what each data set actually represents, added to the fact you make some fairly general assumptions about numbers in the various populations, means your error margins are extremely large.

The actual rates for complications and disease side effects are given here.

Now I have no reason to think there is any gross errors in these numbers, and they are very similar to the statistics found in other countries with similar vaccination schedules. Asinine conspiracy theory aside.

The other issue is the fact that the measles vaccine is so effective, and the vaccinated population so large, that transmission even amongst the unvaccinated is now rare. Measles is rarely seen. Of note here is the fact that even though the vaccinated population is very large over 80% of all measles cases occur amongst the unvaccinated.

That means your risk of measles, even though the disease is rare and herd immunity good, is about 40 times higher if you are unvaccinated.

Measles is extremely infectious. In non vaccinated populations (e.g. Before the vaccine was introduced, or in large communities that do not vaccinate) measles incidence rates are very close to 100%. That is nearly everyone will acquire measles as some stage.

Now in Australia with a fairly high vaccination rate, with a very good vaccine (the measles vaccine has a high effectiveness rate) measles is still rare amongst the unvaccinated. Rare, though still far more common amongst the unvaccinated than the vaccinated. This is essentially the unvaccinated being protected by the large vaccinated population, reducing the transmission of disease amongst the unvaccinated.

This means that there is a skew in absolute numbers towards any vaccine side effect. If a vaccine was 100% effective and everyone was vaccinated, the only issues you would see would be with the vaccine, and not the disease. However the vaccine still represents a decrease in your personal risk.

That is because if you don’t vaccinate and if everyone else doesn’t vaccinate, then the disease returns and the much higher incidence of disease side effects returns.

For measles the incidence of encephalitis is 1 in 1000. This incidence is 1 in 1 000 000 for the vaccine.

Now if over about 95% of the population is vaccinated then measles becomes rare, even amongst the unvaccinated. So the only incidences of encephalitis would be from the vaccine.

However if the vaccine uptake falls below about 80% then the disease spreads easily, and in much greater numbers, amongst the unvaccinated.

That group then gets encephalitis at a rate of 1 in 1000. Or if you like 1000 times more often than the vaccinated group.

Lets make this simple for Christine with a basic example in how to properly compare two different groups with statistics.
I have a population of 100 kids. There are 10 who get measles. 80 of the kids are vaccinated, 20 are not. 7 of the vaccinated get measles, only 3 of the unvaccinated don’t.
Christine maths – 70% of the disease is in the vaxxed! Arghhhh, it doesn’t work!
Real world stats: 7/80 x 100 = 8.75%
(There were 7 cases in a sub population of 80 vaxxed.)
Only 8.75% of vaccinated kids measles.
Now 3/20 x 100 = 15%
(There were 3 cases in a sub population of 20 unvaxxed.)
15% of unvaccinated kids get measles.

It’s the simplest example of statistics, you can’t use raw numbers when you are comparing two populations of disparate size. Of course numbers of notifications are higher in the vaccinated, there are MORE vaccinated people. It’s the PERCENTAGE that’s more important.
I can explain this to my 12 year old niece, but for antivaxxers just don’t get it. It’s like they’ve got their fingers in their ears saying “lalalalalala”.

Thanks also for trying to help, but if you read again my question, you will see that I was not at all looking at the disease incidence rate in the vaccinated. That’s not the comparison I was doing – the government cites 1 in 3000 as the rate of febrile convulsions directly from the MMR vaccine (not indirectly, from a notified case of the disease in the vaccinated).

So for simplicity’s sake, my comparison was assuming 100% vaccine effectiveness. Yet I still ended up with the result that appears to be that the risk is much higher if one vaccinates, so I am trying to establish where I went wrong.

Thanks for trying to help there, but unless you have a special reason (which you may well have, do you?) for discussing such hypothetical situations such as if nobody, or even if just 15% less, of the population, were vaccinated (which change could not occur suddenly without our knowledge anyway, because vaccinated people would have to be “de-vaccinated” for that to occur), those situations are not really related to my question, which is only about determining the risk in the present and foreseeable future.

It seems to me (at this stage) that the best method we have of determining that risk on the disease side is to look at the most recent historical rate of disease complications in unvaccinated children, over the most recent several years for which data is available.

Over the years 2001 to 2007 there were 2.1 million unvaccinated child years (an average of about 18000 children per annual birth cohort x 7 years x 17 birth cohorts), which seems to me to be quite a high sample size. The result, as I said, was 1 neurological complication (of any description, including febrile convulsions or any other) per 140,000 unvaccinated children over their childhood (assuming that all the cases and complications occurred in the unvaccinated).

Are you saying, or would you say, that there a more reliable method of determining that risk than looking at the recent history? If so, I would be appreciative if you could tell me what the method is that you suggest, and what the numerical results are of your prediction, if the risk you get from your calculation is significantly higher than 1 in 140,000.

I did (already) have a look at the page you referenced, thanks, for the rates of disease complications: (http://www.health.gov.au/internet/immunise/publishing.nsf/Content/Handbook-quickguides-sideeffects). However I found that it lacks information that is needed to make a comparison – what stands out especially is that it doesn’t provide the rates at which unvaccinated children are contracting the diseases. If those rates were almost 100% it would not matter much, but the government reports I found indicate that most of the rates are quite low, and some are even zero, e.g. Australia has been declared polio-free since 2000, and there were no tetanus cases reported in any children from 2001 to 2007. Other important information missing includes any mention of, and the rates of, many other acknowledged vaccine adverse effects, such as convulsions.

So that is why I had to look up other government documents for the information I needed to do that calculation.

It’s absolutely appropriate to be discussing hypotheticals, which have a firm basis in reality. No one is talking about having people “de-vaccinated”. You don’t need to do that. All you need is for immunisation rates to drop and you get what is happening in Wales at this very moment, and in Europe in 2011:

Dear reasonablehank (and others),
Thank you to you too for trying to help there with that information, but it seems that perhaps I need to explain again that I am only trying to do a numerical calculation here. I have not asserted that the calculations I have presented are correct, so I myself have not made (or implied) any suggestion(s) on that basis.

On the contrary, I am assuming that I have gone wrong, and on that basis, I am requesting that someone explain, in specific, precise, numerical terms:-
a) what my error is, and, arising from that,
b) what is the correct (or a more accurate) numerical calculation of risk, and applying that,
c) the final, correct (or more accurate) calculated result.

The bottom of line in my calculations is this:
With the cited risk of febrile convulsions alone at 1 in 3000 after the vaccine, and 1 in 700 risk of any neurological complication per case of measles, then even if that 1 in 700 risk applied to febrile convulsions alone, it would still mean that there would need to be a chance of at least as high as around 1 in 4 of an unvaccinated child contracting measles in order to match the risk of febrile convulsions from vaccines.

Applying that bottom line to the outbreak you cited, which was in Europe in 2011:
The number of children aged 1 to 17 years in Europe in 2011 was about 180,000,000, of which about 14,400,000 were not vaccinated against measles.
Even if all 26,000 measles cases occurred only in the latter group (of 14,400,000), that would still work out at only about 1 in 550 unvaccinated children contracting measles.
That measles rate would still be far short of the (greater than) 1 in 4 rate needed for the risk on the disease side to be as high as the risk on the vaccine side.

Looking specifically at France, where the rate of measles was higher:
Making the same assumptions as with Europe, the measles rate in France still works out to be less than 1 in 150, which is still far short of the (greater than) 1 in 4 rate needed for the risk on the disease side to be as high as the risk on the vaccine side.

Even though you have not explained yet how that changes my calculation method, or significantly changes the overall result (could you please do that?), that is interesting, and I find it quite surprising. A febrile convulsion is certainly cited as a complication, so could you please also tell me what type of complication it is deemed as, if not neurological? That would be greatly appreciated.

“Christine”. Your “calculation method” is flawed. You are confusing febrile convulsions with neurological complications. Also, primary febrile convulsions are rare in those >4 yo. What ages are those in the outbreaks?

Could you please first explain further about my confusion of febrile convulsions with neurological complications? Given that febrile convulsions are defined as “complications” and are also obviously neurological, my assumption seems reasonable, so my understanding of why it is false could perhaps lead to my discovery of a major, or wide, (though reasonable seeming) false assumption that I have made. So I REALLY would like an explanation of that, please? That would be greatly appreciated.